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交感神经系统在应激介导的心血管疾病中的作用。

Role of the Sympathetic Nervous System in Stress-Mediated Cardiovascular Disease.

作者信息

Hering Dagmara, Lachowska Kamila, Schlaich Markus

机构信息

School of Medicine and Pharmacology-Royal Perth Hospital Unit, The University of Western Australia, Level 3 MRF Building, Rear 50 Murray Street, Perth, WA, 6000 MDBP: M570, Australia,

出版信息

Curr Hypertens Rep. 2015 Oct;17(10):80. doi: 10.1007/s11906-015-0594-5.

Abstract

A high incidence of acute cardiovascular events and sudden cardiac death following unexpected acute emotional stress or a natural catastrophic disaster has been well-documented over the past decades. Chronic psychosocial factors have been shown to be directly linked to the development of hypertension, cardiovascular disease and stroke. Activation of various neurogenic pathways is an important mediator of acute and chronic stress-induced hypertension and heart disease. Heightened sympathetic activation has been shown to be a critical contributor linking psychogenic effects on cardiovascular regulation to serious and often fatal CV outcomes. Accordingly, several therapeutic approaches that attenuate autonomic imbalance via modulation of increased sympathetic outflow by either non-pharmacological or interventional means have been shown to alleviate clinical symptoms. Likewise stress reduction per se achieved with transcendental medicine has been linked to improved patient outcomes. Therapies that oppose adrenergic activity and/or have the potential to attenuate negative emotions are likely to reduce cardiovascular risk and its adverse consequences attributable to chronic mental stress.

摘要

在过去几十年中,意外的急性情绪应激或自然灾害后急性心血管事件和心源性猝死的高发生率已有充分记录。慢性心理社会因素已被证明与高血压、心血管疾病和中风的发生直接相关。各种神经源性途径的激活是急性和慢性应激诱导的高血压和心脏病的重要介导因素。增强的交感神经激活已被证明是将心理因素对心血管调节的影响与严重且往往致命的心血管结局联系起来的关键因素。因此,通过非药物或介入手段调节增加的交感神经流出以减轻自主神经失衡的几种治疗方法已被证明可缓解临床症状。同样,超觉静坐疗法本身实现应激减轻已与改善患者预后相关联。对抗肾上腺素能活性和/或有可能减轻负面情绪的疗法可能会降低心血管风险及其归因于慢性精神应激的不良后果。

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